Introduction- It is defined as Impaired Glucose Tolerance (IGT) with onset or first recognized during pregnancy. It is an enhancement of the pregnancy-induced physiological changes in carbohydrate metabolism. So, it is also called carbohydrate intolerance and Glucose Intolerance.
All pregnant women get tested in between 24 and 28 weeks of pregnancy for gestational diabetes with 50gm screening GTT (glucose tolerance test) and if the test report founds abnormal the diagnostic test is repeat with 100gm oral glucose tolerance test. However, an expectant mother would be tested frequently if she is over 35 years old, overweight or has a family history of diabetes. In most of the cases, Female develop this condition first time in their pregnancy, but in rare cases, the undiagnosed case of diabetes has worsened.
WHY DOES IT HAPPEN?
During pregnancy, the female body goes through a lot of hormonal changes which produce insulin resistance, that means your body is not using insulin properly. All pregnant women have some insulin resistance during late pregnancy, but if the pancreas cannot make enough insulin to compensate for the level of insulin resistance, gestational diabetes develops. In some cases, people are not aware about their insulin resistance before becoming pregnant. This increases the risk for developing gestational diabetes.
UNDERSTANDING THE RISK FACTORS :-
- Having the age of 25 Years or more
- Having the more weight when entering in pregnancy
- Having previous history of Diabetes
- Having delivered a baby with weight more than 8 pounds
- Having history of PCOS
- Having high BP, heart disease or other medical complication
SIGNS AND SYMPTOMS :-
It is normally asymptomatic but it is detected through routine screening tests during pregnancy. So, the following symptoms may be seen in an Uncontrolled GDM person:
- Unusual thirst
- Sugar in urine
- Frequent urination
- Blurred vision
- Skin infections
- Bladder infections
- Vaginal infections
- Unusual hunger
This is a more common problem during the second semester of the pregnancy. So, the doctor would like to suggest a test between 24 and 28 weeks of pregnancy. If the patient is at higher risk would be screened for gestational diabetes sooner. A Glucose Tolerance Test is done for diagnosing the GDM. In this test, the woman’s blood sample is taken in the morning when she has an empty stomach. Then she is told to drink a glucose solution. After two hours, another blood sample is taken to find out how the body has processed glucose.
OK GOT IT. SO HOW DO I MANAGE IT?
If you are diagnosed with gestational diabetes, don’t panic. It’s totally common and nothing to worry about! It’s definitely best to speak with your doctor and dietitian who specializes in GDM management too. And remember that usually it can be managed through lifestyle changes and diet alone! Sometimes medication is necessary, but that will be determined by your doctor and dietitian based on your blood glucose monitoring.
Mrs. Harshita Jain, Assistant Professor, School of Pharmacy, Career Point University, Kota